management , pharmacy administration , peer review , pre-certification services and preferred provider networks . All self-funded entities that contract with us to provide preferred provider network services utilizes our Hometown Health Network .
Most self-funded entities use a Hometown Health Providers Insurance Company , Inc . identification card to explain the program to which their participants belong . The identification card will vary based on the employer group , but may include the member ’ s out-of-pocket costs , the preferred provider network , pre-certification information and claims address . Please ask to see the identification card during each office visit to ensure that you have the participant ’ s current information . However , possession of the insurance card does not guarantee coverage .
Senior Care Plus Medicare Advantage Plan
Senior Care Plus , a product of Hometown Health Plan , Inc ., is contracted with the Centers for Medicare & Medicaid Services ( CMS ), the U . S . government agency that administers Medicare , to offer a Medicare Advantage Plan without prescription drug coverage ( MA ), and a Medicare Advantage Plan with prescription drug coverage ( MA-PD ). MA-PD plans are available to anyone with both Medicare Parts A and Part B . Open enrollment and the opportunity for Medicare beneficiaries to change to Senior Care Plus occurs in the fall of every year during the Annual Election Period ( AEP ) October 15 through December 7 .
Senior Care Plus coordinates Medicare benefits and offers additional coverage , including Routine Dental , Routine Vision and Hearing Aid benefits .
Senior Care Plus members will obtain care either through the SCP Renown Network ( in which a Renown or Geriatric Specialty Care provider must be used ), the SCP Network , the CareMore Network , or the P3 Network .
CMS currently pays Medicare Advantage Organizations ( MAOs ), like Senior Care Plus , per member , per month amount to cover the cost of Medicare and medical group approved services . The CMS payment amount is based on a risk adjustment component that takes into account the health status and demographic characteristics of each member .
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